Uptake of rheumatology biosimilars in the absence of forced switching

Giuseppe, Daniela Di; Frisell, Thomas; Ernestam, Sofia; Forsblad‐d’Elia, Helena; Lindqvist, Elisabet; Lindström, Ulf; Sjöwall, Christopher; Askling, Johan

doi:10.1080/14712598.2018.1458089

Cited by 15 publications

(27 citation statements)

References 10 publications

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“…In Denmark, it was mandatory to switch all patients treated with INF or ETN to their respective biosimilars, when the biosimilars were marketed 9 14 20. In Sweden, the strategies for both new starts and switching differed across the different counties,19 and in Finland, INF or a biosimilar was used based on exclusive pricing negotiations made in individual hospital districts, whereas the first etanercept biosimilar was not reimbursed in Finland until January 2018. In Iceland, the least expensive bDMARDs are recommended as first-line drugs based on an annual tendering process under the authority of the Icelandic Health Insurance (state insurance company).…”

Section: Methodsmentioning

confidence: 99%

“…In the Nordic region (Denmark, Iceland, Finland, Norway and Sweden), the strategies for transition have differed markedly across the countries, depending primarily on differences in pricing 18. Within Sweden, the uptake was further diversified by separate tender processes in different counties 19. As a result, during the period 2014–2017, biologics-naïve patients with SpA in the Nordic countries have started both originator and biosimilar versions of infliximab and of etanercept.…”

Section: Introductionmentioning

confidence: 99%

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Treatment retention of infliximab and etanercept originators versus their corresponding biosimilars: Nordic collaborative observational study of 2334 biologics naïve patients with spondyloarthritis

et al. 2019

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ObjectiveAlthough clinical trials support equivalence of originator products and biosimilars for etanercept and infliximab, real-world studies among biologics-naïve patients with spondyloarthritis (SpA) are lacking. The objectives were to compare treatment retention in biologics-naïve patients with SpA starting either the originator product or a biosimilar of infliximab and etanercept, and to explore the baseline characteristics of these patients.MethodsPatients with SpA (ankylosing spondylitis/non-radiographical axial SpA/undifferentiated SpA), starting infliximab or etanercept as their first-ever biological disease-modifying antirheumatic drug during January 2014–June 2017 were identified in five Nordic biologics–rheumatology registers. Baseline characteristics were retrieved from each registry; comorbidity data were identified through linkage to national health registers. Country-specific data were pooled, and data on infliximab and etanercept were analysed separately. Comparisons of treatment retention between originators and biosimilars were assessed through survival probability curves, retention rates (2 years for infliximab/1 year for etanercept) and Hazard Ratios (HR).ResultsWe included 1319 patients starting infliximab (24% originator/76% biosimilar), and 1015 patients starting etanercept (49% originator/51% biosimilar). Baseline characteristics were largely similar for the patients treated with the originators compared with the corresponding biosimilars. Survival probability curves were highly similar for the originator and its biosimilar, as were retention rates: infliximab 2-year retention originator, 44% (95% CI 38% to 50%)/biosimilar, 46% (95% CI: 42% to 51%); and etanercept 1-year retention originator, 66% (95% CI 61% to 70%)/biosimilar, 73% (95% CI 68% to 78%). HRs were not statistically significant.ConclusionThis observational study of biologics-naïve patients with SpA from five Nordic countries showed similar baseline characteristics and very similar retention rates in patients treated with originators versus biosimilars, for both infliximab and etanercept, indicating comparable effectiveness in clinical practice.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Treatment retention of infliximab and etanercept originators versus their corresponding biosimilars: Nordic collaborative observational study of 2334 biologics naïve patients with spondyloarthritis

et al. 2019

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“…In the last few years, patent expiration and the resultant loss of market exclusivity has facilitated the introduction of biosimilar agents based on the anti-TNF biologic agents etanercept, infliximab and, most recently in October 2018, adalimumab, to clinical care (18)(19)(20). Rheumatology data from Sweden, where switching to biosimilars is not mandatory, show that when the etanercept and infliximab reference products went off patent, there was an increase in the overall use of biologic treatment, suggesting that biosimilars were not only replacing the reference products, but were increasing the overall rate of biologic therapy initiation (21). This finding reflects the favorable cost differential of the anti-TNF biosimilars (21).…”

Section: Treatment Accessibilitymentioning

confidence: 99%

“…Rheumatology data from Sweden, where switching to biosimilars is not mandatory, show that when the etanercept and infliximab reference products went off patent, there was an increase in the overall use of biologic treatment, suggesting that biosimilars were not only replacing the reference products, but were increasing the overall rate of biologic therapy initiation (21). This finding reflects the favorable cost differential of the anti-TNF biosimilars (21). The recent introduction of adalimumab biosimilars to the European market provides further opportunity to improve cost savings and facilitate access to effective biologic therapy (1,18,20).…”

Section: Treatment Accessibilitymentioning

confidence: 99%

Anti-TNF biosimilars in psoriasis: from scientific evidence to real-world experience

Barker

Girolomoni

Egeberg

et al. 2019

Journal of Dermatological Treatment

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Tumor necrosis factor (TNF) inhibitors account for a large proportion of drugs used to treat psoriasis and are indicated first-line options in certain settings. Several biosimilar drugs based on the anti-TNF agents adalimumab, infliximab, and etanercept are now available for use in patients with psoriasis. The favorable cost differential of biosimilars is expected to improve access to biologic therapy for biologic-naive psoriasis patients, who are often undertreated. Also, substantial cost savings can be made if patients are switched to biosimilars. To date, most clinical testing of anti-TNF biosimilars approved for use in psoriasis has been performed in patients with rheumatoid arthritis, and the results extrapolated to psoriasis. Although this may initially raise concerns for clinicians looking to start their psoriasis patients on biologic treatment with a biosimilar or switch from an original biologic to a biosimilar, the process of extrapolation is tightly regulated and scientifically justified. Furthermore, available real-world evidence of the safety and efficacy of anti-TNF agents in patients with psoriasis complements clinical trial data in patients with rheumatoid arthritis. When equipped with the appropriate knowledge, clinicians should have confidence to use biosimilars for the treatment of psoriasis.

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“…In Asia, biosimilar use within the first year was greater than 10% . A study in Sweden showed that the uptake of biosimilars was over 30% by the end of 2016 . There are various plausible reasons for the low uptake of biosimilars in the United States.…”

Section: Discussionmentioning

confidence: 99%

Patterns of Tumor Necrosis Factor Inhibitor (TNFi) Biosimilar Use Across United States Rheumatology Practices

Bansback

Curtis

Huang

et al. 2020

ACR Open Rheumatology

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Objective. It is unclear if biosimilars of biologics for inflammatory arthritis are realizing their promise to increase competition and improve accessibility. This study evaluates biosimilar tumor necrosis factor inhibitor (TNFi) utilization across rheumatology practices in the United States and compares whether patients initiating biosimilars remain on these treatments at least as long as new initiators of bio-originators.Methods. We identified a cohort of patients initiating a TNFi biosimilar between January 2017 and September 2018 from an electronic health record registry containing data from 218 rheumatology practices and over 1 million rheumatology patients in the United States. We also identified a cohort of patients who initiated the bio-originator TNFi during the same period. We calculated the proportion of biosimilar prescriptions compared with other TNFi's and compared persistence on these therapies, adjusting for age, sex, diagnoses codes, and insurance type.Results. We identified 909 patients prescribed the biosimilar infliximab-dyyb, the only biosimilar prescribed, and 4413 patients with a new prescription for the bio-originator infliximab. Biosimilar patients tended to be older, have a diagnosis code for rheumatoid arthritis, and covered by Medicare insurance. Over the study period, biosimilar prescriptions reached a maximum of 3.5% of all TNFi prescriptions. Patients persisted on the biosimilar at least as long as the bio-originator infliximab (hazard ratio [HR] 0.83, P = 0.07).Conclusion. The uptake of biosimilars in the United States remains low despite persistence on infliximab-dyyb being similar to the infliximab bio-originator. These results add to clinical studies that should provide greater confidence to patients and physicians regarding biosimilar use.

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Uptake of rheumatology biosimilars in the absence of forced switching

Cited by 15 publications

References 10 publications

Treatment retention of infliximab and etanercept originators versus their corresponding biosimilars: Nordic collaborative observational study of 2334 biologics naïve patients with spondyloarthritis

Treatment retention of infliximab and etanercept originators versus their corresponding biosimilars: Nordic collaborative observational study of 2334 biologics naïve patients with spondyloarthritis

Anti-TNF biosimilars in psoriasis: from scientific evidence to real-world experience

Patterns of Tumor Necrosis Factor Inhibitor (TNFi) Biosimilar Use Across United States Rheumatology Practices

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